The nursing home where the victim lived called an ambulance in response to complaints of abdominal pain. It arrived three hours later, a delay that might have led to her death (the details of an investigation by Toronto Emergency Medical Services and the Ontario Ministry of Health have yet to be released). Worse still, paramedics would have reached the scene when she was still alive but were redirected no less than seven times to other emergencies considered to be more critical.

Emergency medical services throughout Canada are struggling to cope with the demands placed on them by an aging population. Because they so often find themselves alone, many elderly citizens often rely on paramedics for help when something goes wrong, including times when the issue isn’t an emergency. Slow ambulance response times have been the result.

This is usually blamed on a lack of paramedics. It is true that budget cuts have lowered their numbers in Toronto despite the fact that emergency patient transport rates have gone up by 36 per cent over the past eight years. Other Canadian cities and towns face the same problem.

Yet there is no guarantee that a hiring blitz will improve things, particularly because hospitals are releasing elderly patients faster than ever. Publicizing response times online — as is happening in Alberta — is also unlikely to make a major difference. Instead, meaningful change will come only when the policies used to respond to emergencies reflect the fact that the population is growing older.

Here, a paramedic — trained in the health needs of seniors — is assigned to a nursing home. Over the course of a 12-hour shift, they work in co-ordination with nursing home staff and the family doctor of the individual being cared for.

The presence of a paramedic onsite means that calls which once led to emergency rooms visits — falls, wounds and issues relating to palliative care are prime examples — are now dealt with at the nursing home. In fact, since the program began two years ago, 1,400 calls have been placed by nursing homes to ECPs. Of those, more than 70 per cent were responded to without going to the hospital.

On top of decreasing the strain facing doctors and nurses and freeing them to focus on actual emergencies, patients are spared the stress of moving back and forth between their room and an unfamiliar hospital setting. What is also important is that the ECP program has not required an extra infusion of money. Instead, the system was simply reorganized to give existing paramedics a new responsibility.

While impressive, this is only a pilot project, one that is based on a long-standing policy used in the United Kingdom, and the city of Sheffield in particular. Recognizing that its aging population was causing a rise in emergency calls and thus negatively impacting ambulance response times, the Paramedic Practitioner Program was launched in 2000. The aim was to develop a policy that would allow elderly patients experiencing minor problems to receive care from paramedics in their homes and nursing residences rather than the hospital.

The results proved so successful that an expanded program is now used throughout the U.K. The paramedics involved have completed specialized instruction that allows them to carry out tasks beyond their traditional role. They can, for example, record patient history, prescribe medication, conduct a physical examination and send patients to specialists.

As a result, well over half of those seen are not sent to the emergency room or even the hospital. And because of this, in the areas it is practised, ambulances are able to meet the U.K. standard call response time of eight minutes in the vast majority of cases. In Canada, nine minutes is the benchmark for cities but this is often missed.

As for costs, here, too, reorganizing the system rather than hiring a vast number of new staff has helped keep expenses in check. In fact, because emergency room and hospital admittances are down, money has actually been saved.

Ontario and Canada as a whole can learn a great deal from all of this. As with all health-care workers, those in the ambulance service want to help people in need, regardless of their age. Reforms based on the Halifax and U.K. models might make it easier for them to do so.

Peter Fragiskatos teaches at Western University in London, Ontario. Follow him on twitter: @pfragiskatos

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